Seizure Simple and Complex Febrile Inpatient Care Guideline - PDF document

Seizure (Simple and Complex Febrile) Inpatient Care Guideline Inclusion Criteria or recurrent febrile seizures s of age ICU status, trauma, chronic systemic illness Complex Febrile Seizure Prolonged duratio�n 5 minutes or focal At onset of febrile illness Returns to neuro baseline Developmentally normal Simple Febrile Seizure Age 6 months –5 years Duration es No focality At onset of febrile illness Returns to neuro baseline Developmentally normal Admit to hospital (NSI if bed available) Neurology consultEEG, awake & asleepMRI scan of brain may be indicated Neurology consult not indicated unless 1 year&#x-700; or 3 years and new onsetMRI scan of brain and EEG not indicated Educate on antipyretics and risk of seizure recurrence Discharge Criteria Seizures controlled or improved Underlying cause evaluated and if identified, treated Patient education completed Considerations Obtain a detailed neurologic examination and developmental assessment. History can reveal possible unrecognized seizure activity. altered mental status, focal 12 months of age. MRI is not recommended in children with a febrile seizure unless the history, physical exam, or neuro/developmental assessment, suggest focality or deterioration/delay, in which case an MRI is the procedure of Treatment with antiepileptic drug is not indicated for simple febrile seizures. Antipyretics, although they may child, will not prevent febrile seizures Children� 12 months at the time of the 1 febrile seizure have approximately a 30% probability of a 2 febrile seizure and those children have a 50% chance of hav

ing at least Patient Education Education should be geared toward decreasing fear and promoting understanding of seizure event. Provide information on how to handle any seizure that may occur Educate on antipyretics and risk of seizure recurrence. Appropriate use of 911 View Instant Healthline videos on CPR and seizure first aid Seizure Recognition and First Aid Revised Care GuidelinesCommittee 3-18-09Reviewed Evidence Based Medicine Reassess the appropriateness of the Care Guidelines as condition changes and 24 hours after admission. This guideline is a tool to aid clinical decision making. It is not a standard of care. The provider should deviate from the guideline when clinical judgment so indicates Inpatient CriteriaSimple Febrile Seizure does not qualify for inpatient unless there is serious parental concern or the etiology of the febrile illness is unclear ReferencesSeizure, Simple and Complex FebrileCare GuidelineAmerican Academy of Pediatrics. Febrile Seizures: Clinical Practice Guideline for the Longterm Management of the Child with Simple Febrile Seizures. Pediatrics, 2008 (121): 12811286.http://pediatrics.aappublications.org/cgi/content/abstract/121/6/1281 American Academy of Pediatrics. Clinical Practice Guideline Neurodiagnostic Evaluation of the Childwith a Simple Febrile Seizure. Pediatrics, 2011 (127) 389394.http://pediatrics.aappublications.org/content/127/2/389.full British Columbia Ministry of Health Services, Guidelines and Protocols Advisory Committee. Febrile Seizures. September, 2010. http://www.bcguidelines.ca/guideline_febrile.html 4-18-12